Computer-based summative assessment of clinical reasoning in clerkships: A mixed-method comparison of key feature problems with case-based multiple choice questions

Background: It is yet unclear if there are differences between using electronic key feature problems (KFPs) or electronic case-based multiple choice questions (cbMCQ) for the assessment of clinical decision making. Summary of Work: Fifth year medical students were exposed to clerkships which ended with a summative exam. Assessment of knowledge per exam was done by 6-9 KFPs, 9-20 cbMCQ and 9-28 MC questions. Each KFP consisted of a case vignette and three key features (KF) using “long menu” as question format. We sought students’ perceptions of the KFPs and cbMCQs in focus groups (n of students=39). Furthermore statistical data of 11 exams (n of students=377) concerning the KFPs and (cb)MCQs were compared. Summary of Results: The analysis of the focus groups resulted in four themes reflecting students’ perceptions of KFPs and their comparison with (cb)MCQ: KFPs were perceived as (i) more realistic, (ii) more difficult, (iii) more motivating for the intense study of clinical reasoning than (cb)MCQ and (iv) showed an overall good acceptance when some preconditions are taken into account. The statistical analysis revealed that there was no difference in difficulty; however KFP showed a higher discrimination and reliability (G-coefficient) even when corrected for testing times. Correlation of the different exam parts was intermediate. Conclusions: Students perceived the KFPs as more motivating for the study of clinical reasoning. Statistically KFPs showed a higher discrimination and higher reliability than cbMCQs. Take-home messages: Including KFPs with long menu questions into summative clerkship exams seems to offer positive educational effects.

Geometric parameters of shoreface profiles of Laptev Sea erosion coast (Table 1)

Field investigations of the Laptev Sea shoreface morphology were carried out (1) off erosional shores composed of unconsolidated sediments, (2) off the modern delta shores of the Lena River, and (3) off rocky shores. It was found that profiles off erosional shores had a concave shape. This shape is not well described by commonly applied power functions, a feature, which is in disagreement with the generally accepted concept of the equilibrium shape of shoreface profiles. The position of the lower shoreface boundary is determined by the elevation of the coastal lowland inundated during the last transgression (at -5 to -10 m) and may easily be recognized by a sharp, an order of magnitude decrease in the mean inclination of the sea floor. The mean shoreface inclination depends on sediment grain-size and ranges from 0.0022 to 0.033. The concave shape of the shoreface did not change substantially during the last 20-30 years, which indicates that shoreline retreat did not slow down and hence suggests continued intensive coastal erosion in the 21st century. The underwater part of the Lena River delta extends up to 35 km offshore. Its upper part is formed by a shallow and up to 18-km wide bench, which reaches depths of 2-3 m along the outer edge. The evolution of the delta was irregular. Whereas some parts of the delta are advancing rapidly (58 m/year), other parts are eroding. Comparison of measured profiles with older bathymetric data gave an opportunity to evaluate the changes of the underwater delta over past decades. Bathymetric surveys of the seabed around the delta can thus contribute towards a quantification of the sediment budget of the river-sea system. In addition, some sections of the Laptev Sea coast are composed of bedrock that has a comparatively low resistance to wave erosion. These sections may supply a considerable amount of sediment, especially if the cliffs are high. This source must therefore also be taken into account when assessing the contribution of shore erosion to the Laptev Sea sediment budget.

Atmospheric, oceanic and hydrological polar motion excitation mechanisms based on a combination of geometric and gravimetric space observations

The goal of our study is to determine accurate time series of geophysical Earth rotation excitations to learn more about global dynamic processes in the Earth system. For this purpose, we developed an adjustment model which allows to combine precise observations from space geodetic observation systems, such as Satellite Laser Ranging (SLR), Global Navigation Satellite Systems (GNSS), Very Long Baseline Interferometry (VLBI), Doppler Orbit determination and Radiopositioning Integrated on Satellite (DORIS), satellite altimetry and satellite gravimetry in order to separate geophysical excitation mechanisms of Earth rotation. Three polar motion time series are applied to derive the polar motion excitation functions (integral effect). Furthermore we use five time variable gravity field solutions from Gravity Recovery and Climate Experiment (GRACE) to determine not only the integral mass effect but also the oceanic and hydrological mass effects by applying suitable filter techniques and a land-ocean mask. For comparison the integral mass effect is also derived from degree 2 potential coefficients that are estimated from SLR observations. The oceanic mass effect is also determined from sea level anomalies observed by satellite altimetry by reducing the steric sea level anomalies derived from temperature and salinity fields of the oceans. Due to the combination of all geodetic estimated excitations the weaknesses of the individual processing strategies can be reduced and the technique-specific strengths can be accounted for. The formal errors of the adjusted geodetic solutions are smaller than the RMS differences of the geophysical model solutions. The improved excitation time series can be used to improve the geophysical modeling.

Geometric Integrability of the Camassa-Holm Equation. II

It is known that the Camassa–Holm (CH) equation describes pseudo-spherical surfaces and that therefore its integrability properties can be studied by geometrical means. In particular, the CH equation admits nonlocal symmetries of “pseudo-potential type”: the standard quadratic pseudo-potential associated with the geodesics of the pseudo-spherical surfaces determined by (generic) solutions to CH, allows us to construct a covering π of the equation manifold of CH on which nonlocal symmetries can be explicitly calculated. In this article, we present the Lie algebra of (first-order) nonlocal π-symmetries for the CH equation, and we show that this algebra contains a semidirect sum of the loop algebra over sl(2,R) and the centerless Virasoro algebra. As applications, we compute explicit solutions, we construct a Darboux transformation for the CH equation, and we recover its recursion operator. We also extend our results to the associated Camassa–Holm equation introduced by J. Schiff.

Desing and Validation of a Light Inference System to Support Embedded Context Reasoning

Embedded context management in resource-constrained devices (e.g. mobile phones, autonomous sensors or smart objects) imposes special requirements in terms of lightness for data modelling and reasoning. In this paper, we explore the state-of-the-art on data representation and reasoning tools for embedded mobile reasoning and propose a light inference system (LIS) aiming at simplifying embedded inference processes offering a set of functionalities to avoid redundancy in context management operations. The system is part of a service-oriented mobile software framework, conceived to facilitate the creation of context-aware applications—it decouples sensor data acquisition and context processing from the application logic. LIS, composed of several modules, encapsulates existing lightweight tools for ontology data management and rule-based reasoning, and it is ready to run on Java-enabled handheld devices. Data management and reasoning processes are designed to handle a general ontology that enables communication among framework components. Both the applications running on top of the framework and the framework components themselves can configure the rule and query sets in order to retrieve the information they need from LIS. In order to test LIS features in a real application scenario, an ‘Activity Monitor’ has been designed and implemented: a personal health-persuasive application that provides feedback on the user’s lifestyle, combining data from physical and virtual sensors. In this case of use, LIS is used to timely evaluate the user’s activity level, to decide on the convenience of triggering notifications and to determine the best interface or channel to deliver these context-aware alerts.d

Geometric characteristics of conics in Bézier form

Derive coordinate-free expressions for geometric characteristics of conics written in Bézier form in terms of their control points and weights.

Multi-agent Architecture for Heterogeneous Reasoning under Uncertainty Combining MSBN and Ontologies in Distributed Network Diagnosis

This article proposes a MAS architecture for network diagnosis under uncertainty. Network diagnosis is divided into two inference processes: hypothesis generation and hypothesis confirmation. The first process is distributed among several agents based on a MSBN, while the second one is carried out by agents using semantic reasoning. A diagnosis ontology has been defined in order to combine both inference processes. To drive the deliberation process, dynamic data about the influence of observations are taken during diagnosis process. In order to achieve quick and reliable diagnoses, this influence is used to choose the best action to perform. This approach has been evaluated in a P2P video streaming scenario. Computational and time improvements are highlight as conclusions.

Distributed Fault Diagnosis Using Bayesian Reasoning in MAGNETO

Many of the emerging telecom services make use of Outer Edge Networks, in particular Home Area Networks. The configuration and maintenance of such services may not be under full control of the telecom operator which still needs to guarantee the service quality experienced by the consumer. Diagnosing service faults in these scenarios becomes especially difficult since there may be not full visibility between different domains. This paper describes the fault diagnosis solution developed in the MAGNETO project, based on the application of Bayesian Inference to deal with the uncertainty. It also takes advantage of a distributed framework to deploy diagnosis components in the different domains and network elements involved, spanning both the telecom operator and the Outer Edge networks. In addition, MAGNETO features self-learning capabilities to automatically improve diagnosis knowledge over time and a partition mechanism that allows breaking down the overall diagnosis knowledge into smaller subsets. The MAGNETO solution has been prototyped and adapted to a particular outer edge scenario, and has been further validated on a real testbed. Evaluation of the results shows the potential of our approach to deal with fault management of outer edge networks.

Towards Understanding Reasoning Complexity in Practice

Although the computational complexity of the logic underlying the standard OWL 2 for the Web Ontology Language (OWL) appears discouraging for real applications, several contributions have shown that reasoning with OWL ontologies is feasible in practice. It turns out that reasoning in practice is often far less complex than is suggested by the established theoretical complexity bound, which reflects the worstcase scenario. State-of-the reasoners like FACT++, HERMIT, PELLET and RACER have demonstrated that, even with fairly expressive fragments of OWL 2, acceptable performances can be achieved. However, it is still not well understood why reasoning is feasible in practice and it is rather unclear how to study this problem. In this paper, we suggest first steps that in our opinion could lead to a better understanding of practical complexity. We also provide and discuss some initial empirical results with HERMIT on prominent ontologies

Aerodynamic study of airfoils geometric imperfections at low Reynolds number

The interest of this study is based on the observation that some manufacturing processes of various vehicles wings, such as unmanned aerial vehicle (UAV), or blades, such as wind turbine blades, or other devices that use aerodynamic profiles, produce imperfections in the leading edge or open trailing edge with bigger thickness than original airfoil, because, for example, they are manufactured in two parts, top surface and bottom surface and subsequently joined. In this last step might appear a sliding between the top surface and the bottom surface having a small step on the leading edge or a small thickness gain can occur on the trailing edge. Normally these imperfections are corrected through a refill and/or sanding processes using many hours of manual labor. Therefore the initial objective of this research is to determine the level of influence in the aerodynamic characteristics at low Reynolds numbers (Lissaman, 1981, Carmichael, 1981, Nagamatsu and Cuche, 1981, Schmitz, 1957, Cebeci, 1989, Mueller and Batill, 1982) of these imperfections in the manufacture, and determine whether there may be a value for which it would not be necessary to correct them

Synchronization waves in geometric networks

We report synchronization of networked excitable nodes embedded in a metric space, where the connectivity properties are mostly determined by the distance between units. Such a high clustered structure, combined with the lack of long-range connections, prevents full synchronization and yields instead the emergence of synchronization waves. We show that this regime is optimal for information transmission through the system, as it enhances the options of reconstructing the topology from the dynamics. Measurements of topological and functional centralities reveal that the wave-synchronization state allows detection of the most structurally relevant nodes from a single observation of the dynamics, without any a priori information on the model equations ruling the evolution of the ensemble

A geometric characterization of the upper bound for the span of the jones polynomial

Let D be a link diagram with n crossings, sA and sB be its extreme states and |sAD| (respectively, |sBD|) be the number of simple closed curves that appear when smoothing D according to sA (respectively, sB). We give a general formula for the sum |sAD| + |sBD| for a k-almost alternating diagram D, for any k, characterizing this sum as the number of faces in an appropriate triangulation of an appropriate surface with boundary. When D is dealternator connected, the triangulation is especially simple, yielding |sAD| + |sBD| = n + 2 - 2k. This gives a simple geometric proof of the upper bound of the span of the Jones polynomial for dealternator connected diagrams, a result first obtained by Zhu [On Kauffman brackets, J. Knot Theory Ramifications6(1) (1997) 125–148.]. Another upper bound of the span of the Jones polynomial for dealternator connected and dealternator reduced diagrams, discovered historically first by Adams et al. [Almost alternating links, Topology Appl.46(2) (1992) 151–165.], is obtained as a corollary. As a new application, we prove that the Turaev genus is equal to the number k of dealternator crossings for any dealternator connected diagram

Geometric tools in Juan de Álava's stonecutting workshop

Stonemasonry of the Gothic vault in its totality is based upon geometry of the line, whereas classic stereotomy relies on the comprehensive knowledge of the surface and the highly sophisticated sides of the voussoirs necessary for its vaults. It is obvious that this leap in the art of construction was paralleled and accompanied by an extension of the horizons of geometry. In Spain, it was made possible thanks to the centuries-old tradition of stone building begun in the most remote medieval times and to the presence of outstanding architects or stonemasons such as Juan de Álava, whose professional work surpassed the established limits and provided the art of building with new instruments.